哮喘联盟

   摘要
   背景:无烟立法可能对分娩结局产生积极的影响。鉴于怀孕期间吸烟和吸二手烟的孕妇的社会经济地位不同，立法可能对一些社会经济群体的影响更大。在这项研究中，我们评估了加拿大魁北克地区2006年的一项在公共场所的禁烟令对早产、小于胎龄出生和出生体重以及产妇教育差异的影响。
   方法:我们分析了魁北克地区2003年和2010年间出生的单胞胎数据。运用逻辑回归分析建立无烟立法与早产（<37周）、极早产（<34周）、小于胎龄（<10%胎龄和性别）、低出生体重（<2500克）和平均出生体重的关联，立法前后调整为长期趋势。交互项被列入评估产妇教育程度不同的影响。
   结果:无烟立法后，每1000个活产婴儿，平均减少3.1个早产儿（95％可信区间为0.1〜6.0），2.3个极早产儿（95％可信区间为0.9〜3.7），5.9个小于胎龄出生儿（95％可信区间为2.6至相关9.3）和1个低出生体重儿（95％可信区间为0.4〜1.6），以及平均出生体重增加17.1克（95％可信区间为10.7至23.6）。立法改善了所有类别教育程度的产妇的分娩结局。
   结论:在魁北克，无烟立法与减少早产和小于胎龄出生及增加出生体重相关。没有令人信服的证据表明立法影响教育梯度的分娩结局。
 

(苏欣 审校)
JEpidemiolCommunityHealth. 2015May18.pii:jech-2015-205779.doi:10.1136/jech-2015-205779. [Epub ahead of print]

 

The impact of smoke-free legislation on educational differences in birth outcomes.
 

McKinnon B1, Auger N2, Kaufman JS1
 

Abstract
BACKGROUND:Smoke-free legislation may have positive effects on birth outcomes. Given that smoking and secondhand smoke during pregnancy vary with socioeconomic position, legislation may have greater effects in some socioeconomic groups. For this study, we evaluated the impact of a 2006 ban on smoking in public places in the Canadian province of Quebec on preterm birth, small-for-gestational-age birth and birth weight, and on educational differences in these birth outcomes.
METHODS:We analysed data on singleton births in Quebec between 2003 and 2010. Logistic regression was used to model the association of smoke-free legislation with preterm birth (<37 weeks), very preterm birth (<34 weeks), small-for-gestational-age birth (<10th centile for gestational age and sex), low birth weight (<2500 g) and mean birth weight, adjusting for secular trends before and after legislation. Interaction terms were included to assess differential effects by level of maternal education.
RESULTS:Smoke-free legislation was associated with average reductions of 3.1 preterm births (95% CI 0.1 to 6.0), 2.3 very preterm births (95% CI 0.9 to 3.7), 5.9 small-for-gestational-age births (95% CI 2.6 to 9.3) and 1.0 low birthweight infants (95% CI 0.4 to 1.6) per 1000 live births, as well as a 17.1 g increase in mean birth weight (95% CI 10.7 to 23.6). Legislation was associated with improved birth outcomes in all categories of maternal education.
CONCLUSIONS:Smoke-free legislation in Quebec was associated with reductions in preterm and small-for-gestational-age births, and an increase in birth weight. There was no compelling evidence that legislation impacted educational gradients in birth outcomes.
 

JEpidemiolCommunityHealth. 2015May18.pii:jech-2015-205779.doi:10.1136/jech-2015-205779. [Epub ahead of print]